KATHY S HERNANDEZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

KATHY S

Last Name

HERNANDEZ

Suffix

Business Name

KATHY S HERNANDEZ MD

Original Issue Date

11/30/1990

Effective Date

11/30/1990

Expiration Date

07/31/1993

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006